TOTAL CROWN / TRIPLE FLAP with skin renewal QUESTIONS

[SERIOUS]

I came across this post about the Total Crown Renewal procedure, and decided to start a fresher one, with what I think are relevant and important questions.

 

I hope Dr. DISTEPHANO and/or one of his representatives can clarify this procedure for all of us, and I hope that actual patients who received that surgery could speak up as well.

 

here are 2 important links that explains how this impressive (but controversial?) procedure is done, and some result pictures:

flechet tissue gain and triple flap

some total crown renewal results

 

(This procedure should NOT be confused with the disastrous Fleming/Mayer flap surgery. Please read the links).

 

My questions are:

 

1- With such stretching of the side and the back of the scalp; could this produce a change in the HEAD SHAPE?

 

By that I mean, like a face lift modify the face, would this surgery, by pulling skin and hair that are usually on the sides (with its "specific hair orientation") look somewhat WEIRD or different than normal when it's on top of the head?

 

2- Could this surgery completely compromise future strip surgeries by eliminating elasticity of the scalp?

 

3- Would'nt this surgery stretch any old scars from previous strip surgeries to a great extent?

 

4- Would this triple flap last step (after tissue gain / scalp extension) leave the patient with no other choices than wearing long hair to hide multiple scars?

 

5- Are ALL or at least an important portion of the follicular units lost (through this complex surgery) used to be transplanted on other areas in the same procedure? or are they just wasted?

 

6- Can we see after pictures of this procedure FROM THE FACE AND SIDES AND TOP, rather than only from the back?

 

Thanks in advance for your answers

[latinlotus]

I am no doctor, but just on a purely logical stand point, this procedure does not make any sense. It is much more invasive than a strip surgery as many scars are required to introduce the silicone strip extender under the scalp. This coupled with the permanent tightness as well as a feeling of something external under your scalp would be unbearable. Also when the silicon is introduced there are great chance of permanent shock loss.

 

Actually, I believe that it is like the disastrous Fleming/Mayer flap surgery with a twist.

[Leeson]

Sounds like a device used during the Spanish Inquisition.

God No! Not the Frechet Extender! I'll Talk!

[latinlotus]

With all objectivity, sometimes the craziest idea from the most insane doctor can sometimes produce a great solution. For instance, at the time, it was a crazy idea to inject a live virus in one's body in order to create a vaccin! Or eating mold in order to fight bacteria (peniciline)!

[mmhce]

I have not read everything. I have heard about the Frechet extender.

 

This process does not seem to deal with the MPB problem at a follicular level.

 

Recall MPB involves a depletion of active hair follicles. There is no net increase in active hair follicles in this procedure.

 

I would not advise investing anymore effort into it.

[hairmanredsox]

Dr. DiStefano will give medical answers to all these questions that have been asked below next week. You will understand the procedure when he is done sharing his knowledge.

 

This procedure has been done by Dr. Patrick Frechet for the past 15 years with 100% success and amazing results in the crown area. I understand the reservation the people on the forum may have since Dr. DiStefano is the only Dr. in the USA performing this procedure. The reason he is the only one in this country is that Frechet personally trained him for a long period of time on this very skilled procedure. A surgeon in France has no reservation teching a Dr. in the USA his skill b/c they have no direct competition with each other.

 

Dr. Distefano was an ER surgeon for years and has the skills and capability to achive Frechet like results with this procedure.

 

We have 65 happy Total Crown Renewal Patients that Dr. Distefano has worked on and we will ask these patients to start to share photo's and stories. I will tell you that I have never seen a procedure gives some much natural looking density in the crown area vs's a hair transplant in all my life. Any patient who comes in for a consult and wants to speak with Total Crown Renewal Patients, we hand them a long list of people to speak with and they feel very comfortable moving forward after that.

 

 

 

Please try to be open minded untill you have all the facts before passing judgment and giving uniformed advice.

 

I am a patient and employee of Dr. Distfano and my advice is not that of a Medical Dr.

[PLEASE GROW PLEASE]

Or eating mold in order to fight bacteria (peniciline

Or popping shrooms to find the purpose of life.

 

I would be interested in hearing more and seeing more then 5 pics.

[latinlotus]

If top doctors/researchers like dr. Cooley or dr. Bernstein amongst others, are not embracing this Frechet Extender, I don't need to waste more time on this.

[latinlotus]

Originally posted by hairmanredsox:

 

This procedure has been done by Dr. Patrick Frechet for the past 15 years with 100% success and amazing results in the crown area.

 

100% success rate, this sounds like a sales job to me.

[mmhce]

100% success rate, this sounds like a sales job to me.

Latinlotus is right. There is no 100% guarantee in any surgery. Even in the gold standard FUT, there is not a 100% sucess rate of all the transplanted hair.

[Eman]

I reserve judgement on this as I don't know anything about this new or newer procedure, but do know a bunch on Fleming/Mayer flap surgery and wouldn't go near the thought or idea of it. And from the sounds of it, I would not even think about this newer option based on what I have looked up until I learned a ton more about it.

 

There have been too many disfigured guys from the flap procedure and even today with FUT!?!

[SERIOUS]

Hairmanredsox,

 

Thanks for your response.

 

We are all looking forward to hear from dr. Distephano soon, and some of his patients as well, with result pics from all angles.

 

This surgery is out of the norm, that is why I'm more than curious for these questions posted above to be answered.

 

I would like to take the opportunity to add a 7th question to the list:

 

7- Who are the best candidates for such a procedure? (for instance, would those with a crown that is not completely bald, or that have a thousand grafts transplanted with a "see through" look, be candidates?)

 

Thanks, looking forward for the answers

[TheEmperor]

This is a scalp reduction with an expander, right?

 

This was used in the USA 10-20 years ago and the problems were scars and stretchback.

 

I agree it could be a great benefit if there was no stretchback. The ability to pull the side hair upward could greatly reduce the amount of area to be covered in the crown, so I'm willing to be open minded, but how does he solve the stretchback problem?

 

Strip doctors can remove 1-2cm, any more and the scar stretches. Here it looks like they are moving the scalp serveral inches on both sides.

[Mark DiStefano]

It is truly regretful that Dr. Rassman was so scarred, both physically and emotionally by scalp reductions performed on him nearly two decades ago. I have known Dr. Rassman since I entered this field from Emergency Surgery almost 15 years ago. He has been a leader, entrepreneur, academician and teacher in the field of hair restoration.

When I entered the specialty of hair transplant surgery, Dr. Rassman had already established his practice and was experimenting with new hair transplant techniques.

With his help, the (then) modern use of the FUE (follicular unit extraction) procedure changed how we view the use of 'plugs' or punches. Most hair transplant surgeons stopped using the punch 10 or more years ago . But with his invention of the FOX?„? Megasession technique, he helped to lead the rest of us to today's FUE method. When he started with this technique, many physicians were skeptical and discredited the 'punch technique. But now, after continued development and refinement of technique, this has opened up an incredible area for donor hair and seemingly scarless (lack of linear scar in the donor area) surgery.

This, too, can be said for the Total Crown Renewal?®. Although it may appear this procedure is based on the 'old' scalp reduction, the Total Crown Renewal?® utilizes different techniques to make dramatic final results.

With the old scalp reduction, the area of balding was pulled closed with from 1 or more scalp reductions. The problem with the 'old' scalp reduction, was that it used mechanical stretch, (brute force), to stretch the hair bearing scalp together. This usually resulted in 'stretch back, phenomena that resulted in production of excessive scar tissue in the area. Also when the number of scalp reductions was done to complete the process, there was a slot formed in the midline of the scalp and the hair was now going in the wrong direction.

 

Dr. Patrick Frechet recognized the problems associated with scalp reductions and (like Dr Rassman) developed new techniques to obviate these problems.

Dr. Patrick Frechet devised a procedure to do the following:

1. Stretch the scalp using biological stretch hence, the use of the extender, as opposed to mechanical stretch, which would thin the scalp, create a large scar and not allow for a complete removal of the bald tissue.

2. Invented the 'extender'

3. Invented the Triple Flap Slot Correction Procedure

This procedure is not the same one that Dr. Rassman had almost 20years ago.

I would like to address the other questions that were asked:

There is absolutely no change in the face, its contour or looks, either head on or in profile.

The crown looks full and there is no 'peculiar look to it, as long as you do not shave your head. (Please refer to patient selection below.)

As for doing the Total Crown Renewal?® (aka extender placement followed by the triple flap) after having a routine HT-- there is an increased risk of complications in performing the Total Crown Renewal?®. . (Please refer to patient selection below.)

Patient selection for the Total Crown Renewal?® (TCR):

Not everyone is a candidate for the TCR. Consideration needs to be scalp tightness, age, past medical history, smoking history as well as previous surgical hair/scalp procedures.

This procedure is not for everyone. It is for a select group of individuals that would otherwise not be able to get the look of complete coverage for their entire bald scalp.

 

 

This procedure is more complicated and requires an experienced surgeon with meticulous skills. The patient must understand that there is more risk involved for loss of the flaps, that would require additional surgery should it occur. However, the rewards are far greater than those of the conventional hair transplant. As for increased scarring, there are definitely more scars involved than in the normal HT, but these would easily be covered as long as one did not shave their head. Frankly, I have had NO patients interested in shaving their head following the Total Crown Renewal?® procedure!

My patients who have had this procedure are very happy with the results to date. No doctor can give the same look of density throughout the entire scalp using standard HT if someone is going to end up a class V or VI. It is not possible today, using only scalp hair.

Dr. Rassman states that this procedure has been discredited by him as well as others. I would agree that the old scalp reduction is not a viable procedure today, but the scalp reduction using the Frechet Extender and the Frechet triple flap slot correction is considered not only acceptable, but cutting edge surgery. It is well established internationally and has been presented at ALL of the world renowned hair restoration meetings. These include the largest organization of hair restoration surgeons, the International Society of Hair Restoration Surgery, The European Hair restoration Surgery, The Orlando Live Surgery Workshop as well as numerous other national hair restoration meetings.

This procedure has been extensively written and taught in ALL of the academic text books on hair restoration, Hair Transplantation by Unger and Shapiro as well as Hair Transplant Surgery by Stough and Haber. Articles on this procedure have also been in the Hair Transplant Forum, the ESHRS periodical, Dermatological Surgery to mention a few. The hair transplant surgical community and professional associations agree that Dr. Frechet's work is outstanding.

Dr. Frechet has performed this surgery in front of live audiences which included Dr. Rassman and the results were always the same ??¦Impressive.

Again, this is not for every patient, it is for a select group who want the best result in terms of density, they do not want to shave their head, they want to show off the look of a full head of hair and realize that there will be more scarring than with a regular HT. They understand that and still they choose to go through it.

Just ask my patient who was a victim of the Rhode Island night club fire who was told there was nothing that could be done for him. Everyday he woke up to a huge scar on the top of his head. Only with the TCR was he able to get his hair back and finally was able to put the physical and emotional pain of the fire behind him. In addition, his full head of hair was restored in 12 weeks rather than 9-15 months needed for traditional hair transplant procedures.

 

Through ISHRS's OPERATION RESTORE, the Total Crown Renewal?® procedure has improved the lives of other patients whose hair and lives have been damaged due to tragic situations.

 

The Frechet and Total Crown Renewal?® procedures are performed throughout the world and are clearly recognized and endorsed within all organizations of the hair transplantation community??¦??¦??¦??¦??¦??¦??¦..just as Dr. Rassman's Fox Megasession?„? was several years ago

[PLEASE GROW PLEASE]

Could you show us pics of patients 5 years down the road

[Mark DiStefano]

My prior post was published on Dr. Rassman's blog: [color:BLUE]http://www.baldingblog.com ,in response to comments made by Dr. Rassman. I felt the content of my response to Dr. Rassman adequately addressed the questions raised in this web site as well.

[latinlotus]

just show us some pics. The ones on the web site's gallery are not very clear or convincing.

[ej]

This looks pretty scary . The only difference I can see from earlier flap surgery is an extender to stretch the scalp. Whichever way you look at it ,it is still " Brute Force " .

 

There was a surgeon in Melbourne Australia who used to do this type of surgery , apparently he used to only offer the surgery to patients with an " extremely lax scalp " and I can understand why .

My question is why risk this " level " of surgery when you can get a great result from a coalition surgeon .

The risks far outweigh any benefits , hair in 12 weeks ( flap) or hair in 12- 15 months (fue) Fue less trauma proven results wins every time for me , also only 1 doc in the USA doing this procedure would concern me as well .

Regards

ej

[Balding Young]

someone on this site mentioned that Dr. Distefano uses multiple blades, which can cause destruction of the limited hair follicles we have. is that true? can Dr. Distefano reply to such an allegation? eager to hear the response.